Rectal cancer: factors predicting short outcomes after radical anterior resection

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COD: 06_2017_06-2725 Categorie: ,

George Ciorogar, Adrian Bartos, Dana Bartos, S¸tefan Cristian Vesa, Miana Pop, Andrei Herdean, Iulia Betea, Anca Ciorogar, Emil Mois,
Florin Zaharie, Cornel Iancu

Ann. Ital. Chir., 2017 88, 6: 505-513

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AIM: This study analyzes risk factors implicated in postoperative complications and mortality after anterior resection in
rectal cancer.
MATERIAL AND METHODS: A total number of 378 patients with anterior rectal resection, diagnosed with rectal cancer
and admitted at the IIIrd Surgery Clinic, “Octavian Fodor” Regional Institute of Gastroenterology and Hepatology,
Romania, between 2009 and 2016. The inclusion criteria were anterior rectal resections with curative visa for rectal
cancer. The complications we assessed are the following: anastomotic fistula, intra-abdominal infections, postoperative
bowel obstruction and wound infection.
RESULTS: There was statistical significance regarding male gender, emergency hospitalization, hypoproteinemia and the
resumption of intestinal transit. Anterior rectal resection of tumors located on the middle rectum was associated with
high rate of anastomotic fistula. Patients with manual suture of anastomosis developed intraabdominal abscess more frequently.
In the multivariate analysis, hypoproteinemia and a number of lymph nodes >1 remained independently associated
with the occurrence of wound infection. The 30-day mortality rate was 4.8% with 18 deaths and morbidity rate
20.6% with 78 cases.
CONCLUSIONS: Major complications after radical resection for rectal cancer are dependent on multiple variables such as
male patients, those admitted in emergency and patients with hypoproteinemia. Location of tumor on middle rectum,
manual suture of anastomosis, number of lymph nodes > 1 were associated with high rate of morbidity. Patients with
coronary heart disease and diabetes mellitus didn’t had statistical significance, but the rate of morbidity and mortality
remains high in this groups.